What is Crohn’s Disease?
Inflammatory bowel disease (IBD) has been a global healthcare problem with increased incidence over the last decades. Crohn’s disease (CD), a form of IBD, is an inflammatory disorder of the intestines in which genetics, environmental factors, intestinal bacteria, gut factors, and an adaptive immune system are contributing factors. Factors that impact on the development and progression of CD are both genetic and environmental in nature. Current evidence suggests that environmental factors, including diet, may be important in the development and progression of CD. Given that diet is something that can be modified, it has become an attractive potential target for both prevention and treatment of CD.
The role of diet in managing Crohn’s Disease
The role of diet in the management of CD is one of the most common questions that patients ask their physicians, yet high quality data to answer this question is limited. The current dietary recommendations for disease prevention and management are scarce and non-evidence based. Numerous diets are actively being studied in Crohn’s the Mediterr; some of the notable ones include the Mediterranean diet, Autoimmune Protocol diet, Crohn’s Disease exclusion diet and low FODMAP diet.
The current diet followed by many is considerably different from the traditional diet of previous generations, when the prevalence of IBD was considerably lower. The Western diet pattern is dominated by increased consumption of refined sugar, omega-6 polyunsaturated fats, and fast food, combined with a deficiency in fruit, vegetables, and fiber. Much of today’s food supply has been processed, modified, stored, and transported over great distances, in contrast to the traditional diet, where food that was produced locally was consumed shortly after harvest. This shift to the Western dietary pattern is hypothesized to increase inflammation in the gut. Data suggests that while refined and processed carbohydrates and sweetened beverages are risk factors for IBD, complex carbohydrates including fruit, vegetables, and fiber should be included in the diet to improve the management of IBD.
Foods that reduce inflammation
The role of diet and probiotics supplementation in restoring the balance of the intestinal microbiota and in improving IBD symptoms is well established. In addition, proponents of the Mediterranean Diet emphasize its anti-inflammatory potential and stress its effectiveness in several other health conditions associated with inflammation. However, the abundance of fiber of this dietary pattern could make it unsuitable for patients with gut inflammation. The Mediterranean and vegetarian diets are rich in fruits, vegetables, fish oil, whole grains, and olive oil, which provide nutrients such as vitamin D, essential fatty acids, minerals, and fiber. These foods maintain a healthy intestinal microbiota preventing inflammation.
Previous research led to a hypothesis that diet, and particularly red meat consumption, may be associated with relapse of CD. However, nearly all of the prior data are from observational rather than interventional studies. In one particular study, red meat was one of the foods that patients with CD reported to worsen symptoms, and it was commonly avoided. However, dietary patterns are a complex construct, because certain foods tend to be consumed together and because foods also contain additives, contaminants, and chemical products of preparation, among other things. Similarly, according to Kelder and colleagues, an excessive consumption of animal proteins is associated with an increased risk of developing CD. This suggests an association between red meat consumption and CD, while dairy product consumption does not seem to have an impact on CD. The most recent studies have shown that red meat does not in fact have a significant impact on CD symptoms and inflammation of the gut.
While diet definitely plays a role in CD progression, it does not seem that minimizing red meat necessarily plays a major role. In conclusion, most recent research (a large random control study) has found that among patients with CD in remission, their level of consumption of red and processed meat was not associated with time-to-symptom relapse. Therefore, there does not seem to be a need for people with CD to minimize red meat consumption unless of course directed to by a healthcare professional.
- Crohn’s disease
- The role of diet in the prevention and treatment of Inflammatory Bowel Diseases
- Nutritional Immunity and Fungal Pathogenesis: The Struggle for Micronutrients at the Host-Pathogen Interface
- A Diet Low in Red and Processed Meat Does Not Reduce Rate of Crohn’s Disease Flares
- Correlation network analysis reveals relationships between diet-induced changes in human gut microbiota and metabolic health
- The Importance and Challenges of Dietary Intervention Trials for Inflammatory Bowel Disease